Embryo Project Encyclopedia

During the mid-twentieth century, Virginia Apgar worked as an obstetrical anesthesiologist and gave drugs to women that reduced their pain during childbirth in the US. In 1953, Apgar created a scoring system, called the Apgar score, that uses five measurements, including heart rate and breathing rate. The Apgar score evaluates newborn infants and determines who needs immediate medical attention. Apgar's work helped decrease infant mortality rates. As of 2020, hospitals around the world use the Apgar score.

Isotretinoin is a molecule and a byproduct (metabolite) of vitamin A, and in greater than normal amounts in pregnant women, it can cause fetal abnormalities including cleft lips, ear and eye defects, and mental retardation. Isotretinoin is commonly called by its trade name Accutane, and it's a chemical compound derived from vitamin A, or retinoic acid. Doctors prescribe isotretinoin to treat severe acne. For pregnant women, too much vitamin A or isotretinoin can also cause greater than normal rates of stillbirths and fetal disintegrations after the ninth week of gestation. Women who use isotretinoin during the first trimester of their pregnancies, even in small amounts, risk defects to their fetuses such as external ear malformations, cleft palates, undersized jaws (micrognathia), a variety of heart defects, buildups of fluids inside the skulls that leads to brain swelling (hydrocephalus), small heads and brains (microcephaly), and mental retardation.

The Planned Parenthood Committee of Phoenix was established in 1942 to expand Arizona women's access to family planning resources. The Planned Parenthood Committee of Phoenix was formed through the merging of The Mother's Health Clinic in Phoenix, Arizona, with the national Planned Parenthood Federation of America. The clinic was primarily based within the Phoenix Memorial Hospital campus but expanded to other locations in the late 1960s. Until it became Planned Parenthood of Central and Northern Arizona in 1978, the Planned Parenthood Committee of Phoenix provided Arizona women with contraception, initially in the form of diaphragms and spermicide, and later including the birth control pill. It also provided educational information on relationships, sex, contraception, and infertility.

Josef Warkany studied the environmental causes of birth defects in the United States in the twentieth century. Warkany was one of the first researchers to show that factors in the environment could cause birth defects, and he helped to develop guidelines for the field of teratology, the study of birth defects. Prior to Warkany’s work, scientists struggled to explain if or how environmental agents could cause birth defects. Warkany demonstrated that a deficiency or excess of vitamin A in maternal nutrition could cause birth defects. He also established that mercury in teething powders increased infant mortality rates. Warkany showed how substances outside the human body could adversely affect conception, growth, and development of the human fetus in utero.

In its 1993 decision Daubert v. Merrell Dow Pharmaceuticals, Inc., the US Supreme Court established the Daubert Standard for evaluating the admissibility of scientific knowledge as evidence in US federal courts. When it began in trial court, the case addressed whether or not Bendectin, an anti-nausea medication taken during pregnancy, caused birth defects. However, after the trial court dismissed the case for lack of admissible evidence, Daubert v. Merrell Dow Pharmaceuticals, Inc. advanced through appeals courts to the US Supreme Court, where the Justices defined the criteria by which scientific knowledge, which for them included a least theories based on evidence, expert testimony from scientists, and scientific techniques, could be introduced and used in court cases as evidence. The Daubert Standard states that the judge of a case is responsible for determining what claims are admissible as scientific knowledge and as evidence in the case. The admissibility should be determined by the falsifiability of the claims, by whether or not they had passed peer reviewed, by the general scientific acceptance of the claims, and for techniques, by their error rates of the techniques. Daubert v. Merrell Dow Pharmaceuticals, Inc. set a landmark precedent in the US judicial system and influenced most subsequent legal cases that appealed to science to establish facts in trials.

In the 1989 case Webster v. Reproductive Health Services, the
US Supreme Court upheld the constitutionality of a Missouri law regulating abortion care. The
Missouri law prohibited the use of public facilities, employees, or
funds to provide abortion counseling or services. The law also placed restrictions on physicians who provided
abortions. A group of physicians affected by the law challenged the
constitutionality of certain sections of it. The US federal district
court that first heard the case ruled many of the challenged sections of
the law unconstitutional. The Missouri attorney general then appealed
the case to an US federal appeals court and eventually to the US Supreme
Court in Washington, D.C. In a five to four decision, the US Supreme
Court overturned the decisions of the lower federal courts, ruling that
it was constitutional to prohibit public funds, facilities, and
employees from providing abortion care. In doing so, the Supreme
Court upheld a state law that limited women’s access to abortions
and established a precedent that states could apply restrictions to
abortion care.

Margaret Higgins Sanger advocated for birth control in the United States and Europe during the late nineteenth and early twentieth centuries. Although people used contraceptives prior to the twentieth century, in the US the 1873 Comstock Act made the distribution of information relating to the use of contraceptives illegal, and similar state-level Comstock laws also classified discussion and dissemination of contraceptives as illegal. Sanger helped to repeal the Comstock Act and similar laws so that women could legally use contraceptives to control their fertility and the sizes of their families. In 1916, Sanger opened the first birth control clinic in the US in New York City, New York. Later in life, Sanger formed several advocacy organizations that promoted access to contraception, including the Planned Parenthood Federation of America. Sanger's advocacy increased women's access to contraception and helped change the United States' social and legal perceptions of birth control.

Barry Morris Goldwater was a Republican Arizona Senator and US presidential candidate in the twentieth-century whose policies supported the women's reproductive rights movement. Goldwater, a businessman and Air Force reservist, transitioned into politics in the 1950s. He helped align popular support for a conservative Republican Party in the 1960s. Throughout his life, he worked to maintain personal liberty and to limit governmental intrusion into citizens' private lives. Goldwater, influenced by his wife Margaret (Peggy) Goldwater, supported women's rights to abortions. Goldwater's advocacy and support for reproductive rights assisted in the foundation of the Planned Parenthood chapter in Phoenix, Arizona, and for national policies promoting birth control and abortion rights.

The 1973 case Nelson v. Planned Parenthood Center of Tucson established the legality of abortion in Arizona. The Arizona Court of Appeals ruled that the Arizona Revised Statutes 13-211, 13-212, and 13-213, collectively called the Arizona abortion statutes, were unconstitutional. The statutes had made illegal receiving, providing, or advertising abortions. After the Arizona Appeals Court heard the case, it decided that the Arizona abortion statutes were constitutional. However, two weeks later the US Supreme Court decided in Roe v. Wade (1973) that abortion was constitutional at the federal level. The Arizona court followed the precedent set by the US Supreme Court and amended its decision to rule that the Arizona abortion statutes were unconstitutional. Afterwards, Planned Parenthood, other family planning clinics, and hospitals were legally allowed in Arizona to advertise, discuss, and offer abortions as an option to their patients.

In March 1996, the National Academy of Sciences of the United States released 'Veterans and Agent Orange Update 1996: Summary and Research Highlights,' which summarized research on the health effects of Agent Orange and other herbicides used in the Vietnam War. In their 1996 report, the National Academy connects Agent Orange exposure with two health conditions: spina bifida, a birth defect that occurs when the spinal cord develops improperly, and peripheral neuropathy, a nervous system condition in which the peripheral nerves are damaged. Spina bifida was the first birth defect to linked to Agent Orange exposure. The resulting disability compensation for affected children, as a result of the conclusions in the 1996 report, marked the first time that the US Veterans Administration addressed the health outcomes of veterans' families, and not exclusively veterans themselves.